NPIMap

Organization Active NPI

Oregon Spine Care LLC

Doing business as Oregon Spine Care

  • Orthopaedic Surgery of the Spine Physician
  • Tualatin, OR
National Provider Identifier
1376972182
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
MD26166 Issued in OR
Legal business name
OREGON SPINE CARE LLC
Doing business as
Oregon Spine Care
Practice address
19255 SW 65TH Ave
Suite 200
Tualatin, OR 97062-7451
Phone
(503) 828-1150
Fax
(503) 828-1160
NPI assigned
Nov 2, 2013
Last updated
Oct 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert L Tatsumi, MDNPI 1992828800
Title
Owner
Phone
(503) 828-1150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X MD26166 OR Primary

Addresses

Primary practice location

19255 SW 65TH Ave
Suite 200
Tualatin, OR 97062-7451

Mailing address

19255 SW 65TH Ave
Suite 200
Tualatin, OR 97062-7451
Phone (503) 828-1150

Other names 1

  • Oregon Spine Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140326002417 OR Part B Supplier - Clinic/Group Practice 4183855604 Receives reassigned benefits from 6 practitioners
Practice locations: Tualatin, OR

National Provider Directory

National Provider Directory

Locations

19255 SW 65th Ave
Tualatin, OR 97062

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1376972182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19255 SW 65TH AVE",
            "address_2": "SUITE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627451",
            "telephone_number": "503-828-1150",
            "fax_number": "503-828-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19255 SW 65TH AVE",
            "address_2": "SUITE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627451",
            "telephone_number": "503-828-1150",
            "fax_number": "503-828-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON SPINE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "TATSUMI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-828-1150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OR",
            "license": "MD26166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Spine Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oregon Spine Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.